Quality of care is one reason we are promoting Expanded Function Dental Assistants (EFDAs). Compare EFDAs to dental therapists, which is what will soon be proposed to supposedly solve the access to care problem.
EFDAs works under the supervision of a dentist, so no dental work leaves the office until it meets the quality standards expected by the dentist. If an assistant is not doing high quality work, find another. There are EFDAs with excellent skills already working all over the country.
Dental therapists work independently. They diagnose and treat without oversight by a dentist. Once they are licensed, they do as they wish.
EFDA is not a new position. In fact, I used them as early as 1980 while working in the Indian Health Service. One of my assistants created restorations much better than my own. They have been used in many states for over 30 years. We had a presentation at the recent Wisconsin Dental Association House of Delegates meeting in Stevens Point where two representatives from Ohio – one of which was a private-practice dentist – spoke about the efficiencies and advantages of EFDAs.
We need to promote this solution to help us reach those who claim they cannot afford dental care. This position will allow us to provide more restorative services in the time we are in our offices.
Spot on. Pennsylvania has used EFDAs successfully since I was in training there in the late 70s and early 80s. Their skills were impressive and their pride improved the office atmosphere. Dentists have complete control over quality of care and they provide a good example of a means to leverage your time cost effectively. Dental therapists represent a potential threat to our profession due to their lack of training in differential diagnosis in particular. Seek out the opinions of our colleagues in Minnesota before allowing this to happen here. EFDAs are clearly a better choice in my opinion.
Thanks for your post, Dr. Clemens. I appreciate your clarity and I value your opinion as someone who has already worked with EFDAs. I also worked with EFDAs in my residency at an IHS clinic. Skills varied just like with all assistants (and dentists) but they took great pride in their work and produced some beautiful results.
First off, I am all for EFDA’s. I think it is the most viable way to try to improve access to care in a timely and cost-effective manner. Other options may become available as we continue to address this issue. People and powers outside of the dental office may try to decide what is best for us in this respect. I think we need to be at the table if this happens so that we have a say on how this may be defined and accomplished. It’s our offices and our teams. The future of any options available will be decided by what works best for our own practices. So now I’m going to say it—- DT’s may very well happen, but will it stand the test of time. Some offices may be able to make this work, but not mine. We know that EFDA’s are a great way to address access and will stand the test of time (they already have as pointed out earlier). I just want to make sure that any other options have our input so that it is done for the right reasons. That means it should benefit our offices and our patients to continue the best dental care that we can.
If its a choice between EFDA or DT then clearly the former is preferable. I’m a little unsure of how this affects access however. Will restorations done by EFDA’s be at a lower fee as Dave seems to suggest and if so how does this affect third party UCR,reimbursement etc? Seems as if there could be a lot of unintended effects and potential pitfalls.